pooja khatri, md, msc professor of neurology university of … · strokenet infrastructure •ncc...
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Industry Disclosures
• Dept received funds from Genentech (PRISMS) and Lumosa(consultation, DSMB) Johnson & Johnson shortly (ENDO LOW IIS Grant)
• Personal consultation to Biogen (DSMB), Greenwich, PTC therapeutics, and medicolegal cases
NIH Trial Networks In Context
• NETT– Phase III trials in emergency neurology
• NeuroNEXT– Pilot trials in the neurosciences
• StrokeNET – All phases in stroke (treatment, prevention, recovery)
• SIREN– All phases in emergency neurology (except stroke), cardiovascular, respiratory, and trauma
StrokeNET Infrastructure
• NCC (National Coordinating Center)– University of Cincinnati– Multiple PIs: Joe Broderick, MD and Pooja Khatri, MD, MSc
• NDMC (National Data Management Center) – Medical University of South Carolina (MUSC)– Multiple PIs: Yuko Palesch, PhD and Wenle Zhao, PhD
• RCCs (Regional Coordinating Centers)– 27 RCCs with 300+ clinical performance sites
• Competitive renewal just completed
Key Elements for RCCs
• Funds for program manager • Funds for trainee• Master trial agreement requirement• Central IRB requirement
Working GroupsAcute Chairs: Pooja Khatri MD, MS / Jeff Saver, MD
Prevention Chairs: Marc Chimowitz, MD / Ralph Sacco, MDRecovery Chairs: Steve Cramer, MD / Steven Wolf, MD
Cores and Advisory Committees
Cores:• Education (Dawn Kleindorfer)• Imaging (Max Wintermark)
Advisory Committees• Ethics and Competing Trials (Jennifer Majersik) • Minority Recruitment and Retention (B. Boden Albala)• Interventional (Colin Derdeyn)• Pediatric (Heather Fullerton)
Trial Concepts
• Go through StrokeNet if NIH funding and 5+ centers planned
• Arise from within or outside StrokeNet• Process involves interaction with scientific input (not a review) and trial feasibility assessment within the network
Trial Development Process
Applicant submits protocol concept to
NINDS
Applicant discusses concept with working
GroupESC Approval
Feasibility review and development of
budgetScientific Peer Review Council Review
Final Protocol development with
NetworkcIRB approval GO!!
Education Core
• Activities– Supervision of the RCC Training Programs– Feedback to trainees about research projects– Didactic and professional development webinars
• https://www.nihstrokenet.org/webinars
StrokeNET TrialsTrials Concept PI Status
CREST 2 Ph 3 Asx ICA stenosis: CEA/Stenting vs MM Brott Enrolling
MISTIE III Ph 3 Minimally Invasive Surgery + Rt‐PA for ICH Hanley Follow Up
iDEF Ph 2 Deferoxamine (iron chelation) for ICH Selim Done
TeleRehab Ph 3 Home telerehab for stroke motor recovery Cramer Done
DEFUSE III Ph 3 Mechanical thrombectomy at 6‐16 hrs Albers Done
CREST H CREST 2 Ancillary study: whether cognitive impairment is reversible with ICA tx
Marshall Enrolling
ARCADIA Ph 3 Apixaban for atrial cardiopathy Elkind, Kamel, Tirschwell, Longstreth
Enrolling
MOST Ph 3 Antithrombotics (eptabitide / argatroban) as adjunct to alteplase
O Adeoye, A Barretto, J Grotta, J Broderick
Soon
SLEEP SMART Ph 3 Early APAP treatment of OSA for prevention and stroke recovery
Brown, Chervin Soon
TRANSPORT2 Ph 2 Transcranial direct current stimulation for motor recovery (in setting of CIMT)
Schlaugg, Feng Soon
SATURN Ph 3 Statin discontinuation after lobar ICH Selim Soon
iACQUIRE Ph 3 Intensive Rehab for Infantile Ischemic Stroke Lo, Ramey Likely soon
ASPIRE Ph 3 Apixiban for afib after ICH Sheth, Kammel Likely soon
SN also contributes to efforts in enrollment in SHINE
Considerations for New Multicenter Trialists
• Join Steering Committee webinars if at SN site
• Watch educational webinars (open to all)– https://www.nihstrokenet.org/webinars
• Suggest Mult PI model with senior trialist (up to 4 PIs)
• Get in touch at least 6 months before the NIH deadline desired for application